Glen Scott Smith, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G42987 Issued in CA

Practice address

2501 E Chapman Ave
Orange, CA 92869-3204

Phone

(714) 633-1011

Fax

(714) 633-4883

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• G Scott Smith Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

St. Louis College of Physicians and Surgeons, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1912096579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-633-1011",
            "fax_number": "714-633-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-633-1011",
            "fax_number": "714-633-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GLEN",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G42987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gsmith1373789@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2501 E Chapman Ave",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928693204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "G",
            "last_name": "SMITH",
            "middle_name": "SCOTT",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• David C Smith, MD
• Devyn Smith
• Donnice Mechelle Smith
• Edith Caroline Smith, N.P.
• Ellyn Allyse Smith, M.D
• Hannah Smith, OTR/L
• Ian C Smith
• Jamie Lee Smith
• Janetta Theresa Smith
• Jennifer Smith, BCBA

• Family Medicine Physician in Orange, CA
• Providers in Orange, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.